Biomedical subjects

J W Pearce

Publications and source records attributed to J W Pearce.

At least 19 recordsLinked to original sources

PubMed2004

Toll-like receptor 4 in normal and inflamed lungs and other organs of pig, dog and cattle.

Bacterial diseases, especially those of the lung caused by Gram-negative bacteria, inflict significant economic loss associated with mortality and morbidity in domestic animals. Toll-like receptor 4 (TLR4) has recently been recognized as a major receptor for cellular interactions with lipopolysaccharides derived from Gram-negative bacteria. However, there are no data on the expression of TLR4 in various organs of domestic animals. We performed immunohistochemistry and immuno-gold electron microscopy to localize TLR4 in lung and seven other organs from normal pig, dog and calf (n=2 each) and in inflamed lungs from calves (n=4) challenged with Mannheimia hemolytica. The data show TLR4 in macrophages in lung, small intestine, liver and spleen in all the species and pulmonary intravascular macrophages in calves and pigs. Epithelium in lung, small intestine, cornea and convoluted and straight renal tubules was stained for TLR4. Vascular endothelium of large blood vessels only in lungs and skin was positive, and skeletal muscles were negative for TLR4. In inflamed lungs, airway epithelium showed reduced staining for TLR4 while staining in macrophages remained unaltered. These are the first immunocytochemical data on TLR4 expression in domestic animal species and show similarity in TLR4 staining in macrophages, epithelium and vascular endothelium among dog, pig and cattle.

Animals↗

PubMed2001

Psychotherapeutic approaches to children in foster care: guidance from attachment theory.

The diverse psychological and emotional problems of foster children are reviewed, and an explanatory, interactional model based upon the key concepts of developmental psychopathology is described. The constructs of the internal working model and interpersonal schema, derived from attachment theory, are pathogenic mechanisms that contribute to the emergence of psychopathology in this population. The paper presents a general orientation to therapeutic work with foster children and describes some specific interventions based upon this interactional model. While attachment theory has much to offer clinicians, insecure attachment is just one of a number of risk factors; a comprehensive approach, both in terms of conceptualizing foster childrens' problems and treating them, is essential.

Child↗

PubMed1999

How IDSs can make their risk contracts more profitable.

To understand the causes of financial losses associated with risk arrangements, and eliminate those deficits, integrated delivery systems (IDSs) need to be able to perform detailed analyses on all aspects of their utilization data. Evaluations of utilization should begin with a traditional variance analysis to pinpoint areas where costs are higher than anticipated. Then, a series of increasingly specific analyses should be performed on utilization data within those areas. Often, losses may be attributable to the inability of primary care physicians to serve as effective patient care managers. IDSs, therefore, should compare the practices of their primary care physicians and share results in a way that highlights each physician's performance while ensuring physician anonymity. IDSs should take steps to reduce future losses by providing physicians and utilization management staff with information that will help them control costs, developing a performance-improvement plan for primary care physicians, and implementing payment incentives for physicians.

Benchmarking↗

PubMed1999

Annual audits of IDS risk contract settlements improve payment accuracy.

Integrated delivery systems (IDSs) should conduct annual audits of payers' settlements under risk contracts to verify that the payer attributed the appropriate amounts of revenue and charged the appropriate claims expenses to the IDS. In particular, IDSs should verify that payers calculated revenues and expenses based on consistent member counts and that the determined commercial revenue was based on the actual premiums paid. IDSs also should determine whether payers have used appropriate demographic factors and countywide rates as a basis for determining Medicare revenue, charged the IDS for claims only for valid members, paid capitated providers the correct capitation amounts, and used appropriate historical data to estimate the amounts of incurred-but-not-reported claims attributed to the IDS.

Accounts Payable and Receivable↗

PubMed1998

How should data be analyzed and reported in a risk-contracting environment?

Integrated delivery systems (IDSs) that enter into risk contracts with payers need sophisticated data analysis and reporting capabilities to ensure proper payment and to manage utilization. An IDS can develop these capabilities by following a six-step process: It should develop an IDS data management structure, obtain all requisite data, review and refine the data, consolidate the data, create a relational database, and develop a reporting structure. The reporting structure should consist of a set of standard reports and the ability to generate additional targeted reports that facilitate analysis of specific aspects of utilization and financial performance.

Capitation Fee↗

PubMed1995

Endogenous event-related potentials in term and preterm infants.

Event-related brain potentials generated in an auditory oddball paradigm were recorded in term and preterm infants. The amplitudes of these brain potentials were significantly larger when generated by a rare improbable stimulus compared to a common frequently presented stimulus. While the magnitude of this novelty detection effect depended on the gestational status (full term and preterm) of the infant, these findings suggest the developmental continuity of cognitive processes such as selective attention and recognition memory ordinarily observed in adults. The significant relationship between the amplitudes of these brain potentials and states conducive for sustained attention in infants further supports the endogenous nature of these potentials.

Arousal↗

PubMed1994

Attachment theory and its implications for psychotherapy with maltreated children.

The implications of attachment theory for clinical work with maltreated children are examined with particular emphasis upon the therapeutic relationship. Psychological and behavioral problems related to an insecure attachment often emerge in the relationship between the child and therapist. The clinician can intervene in the context of the relationship to enable the child to modify negative and pessimistic beliefs and expectations of others and of the self. The article describes a number of therapeutic strategies, as well as other issues relevant to therapists who utilize this theoretical and clinical orientation in their work with this population. A focus upon the therapeutic relationship is just one component of an overall plan to help abused children remediate some of their significant problems.

Adaptation, Psychological↗

PubMed1989

Childhood developmental changes in the auditory P300.

In this study we investigated developmental changes in the auditory P3 latency from childhood to adolescence. Event-related potentials evoked by improbable auditory stimuli were recorded from 35 normal children between the ages of 5 and 13 years. Regression analyses showed significant age trends in the auditory P3 latency. Latencies decreased at a rapid rate (Cz: 20.34 msec/yr; Pz: 19.27 msec/yr) from childhood to adolescence, suggesting an increased efficiency in processing information as children mature. This rate was linear or constant in nature as evidenced by the failure of the quadratic and cubic components to significantly increase predictability of the regression equation. The slope of the P3 latency/age regression line was also shown to be influenced by the interactive effects of task difficulty and maturation. It was hypothesized that neuro-developmental processes (increased myelination and dendritic arborization) may underlie the maturational changes observed in the P3 latency during childhood.

Adolescent↗

PubMed1988

Identifying sleep apnea from self-reports.

An apnea score (AS) was developed as a potential screening tool for sleep apnea. This was based on self-report questionnaire responses of 76 sleep disorder center patients and 20 sleep survey volunteers. Twenty volunteers and 23 patients (group I) comprised the initial AS development group. Their questionnaire responses were compared to polysomnographic apnea indexes (AI) and apnea plus hypopnea indexes (AHI). Stepwise multivariate discriminant analysis was used to test whether or not selected group I questionnaire responses could be used to correctly classify respondents into apnea (AI or AHI greater than 5) or nonapnea (AI, AHI less than or equal to 5) groups. Self-reports of "stops breathing during sleep," "loud snoring," and history of adenoidectomy best discriminated normal (AI less than or equal to 5) from apnea (AI greater than 5) cases. The AS derived from group I responses to these three variables was then computed for group II (n = 53). After examination of the AS results, the AS was modified to include just "stops breathing" and "loud snoring" and the AI criterion was raised to 10 per hour. This revised AS correctly identified 100% of the cases with moderate-severe sleep apnea (AI or AHI greater than 40) and 70-76% of all sleep apnea cases with AI or AHI greater than 5. Predictive accuracy was 88% for AI greater than 10. The two questions that comprise the AS should be incorporated into risk appraisal instruments or interviews to screen for sleep apnea.

Adenoidectomy↗

PubMed1988